Provider Demographics
NPI:1568794964
Name:HOLCOMB, HUGH K II (CRNA)
Entity Type:Individual
Prefix:
First Name:HUGH
Middle Name:K
Last Name:HOLCOMB
Suffix:II
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:ELIHUE
Other - Middle Name:K
Other - Last Name:HOLCOMB
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1389
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35807-0389
Mailing Address - Country:US
Mailing Address - Phone:205-979-5882
Mailing Address - Fax:205-979-1248
Practice Address - Street 1:911 BIG COVE RD SE
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-3750
Practice Address - Country:US
Practice Address - Phone:205-979-5882
Practice Address - Fax:205-979-1248
Is Sole Proprietor?:No
Enumeration Date:2010-02-10
Last Update Date:2010-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-098507367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL511-03074OtherBC BS OF AL
AL118099Medicaid
AL1568794964OtherTRICARE
AL1568794964OtherTRICARE